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Home invasive mechanical ventilation in Finland in 2015–2019

Petra Kotanen, Hanna-Riikka Kreivi, Aki Vainionpää, Hannu Laaksovirta, Pirkko Brander, Waltteri Siirala
ERJ Open Research 2020 6: 00223-2020; DOI: 10.1183/23120541.00223-2020
Petra Kotanen
1HUH Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
2Doctoral Programme in Clinical Research, University of Helsinki, Helsinki, Finland
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  • For correspondence: petra.kotanen@hus.fi
Hanna-Riikka Kreivi
1HUH Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Aki Vainionpää
3Department of Rehabilitation, Seinäjoki Central Hospital, Seinäjoki, Finland
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Hannu Laaksovirta
4HUH Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Pirkko Brander
1HUH Heart and Lung Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Waltteri Siirala
5Dept of Anaesthesiology and Intensive Care, Turku University Hospital and University of Turku, Turku, Finland
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  • FIGURE 1
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    FIGURE 1

    Prevalence of home mechanical ventilation in Finland on 1 January 2019. Mean prevalence of home mechanical ventilation in five university hospital areas in Finland. The mean prevalence in Finland was 2.0 in 100 000 inhabitants. The mean population was 4.6 million adults (2018). OUH: Oulu University Hospital; KUH: Kuopio University Hospital; TAUH: Tampere University Hospital; TUH: Turku University Hospital; HUH: Helsinki University Hospital.

  • FIGURE 2
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    FIGURE 2

    New and deceased home invasive mechanical ventilation patients in Finland in 2015–2019.

  • FIGURE 3
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    FIGURE 3

    Diagnostic groups of home invasive mechanical ventilation patients on 1 January 2019. Sector diagram representing proportions of the six diagnostic groups using long-term home invasive mechanical ventilation in Finland. The motor neurone disease group includes motor neurone disease, amyotrophic lateral sclerosis and spinal muscular atrophy patients. The spinal cord injury group includes both traumatic and nontraumatic injuries. The muscular diseases group includes congenital muscular dystrophies, Becker and limb-girdle muscular dystrophies, nemaline myopathy, myotonic dystrophy and cerebral palsy. The miscellaneous group includes congenital deformities, basal ganglia disease, encephalitis, Larsen syndrome, other polymyositis, central sleep apnoea, Guillain–Barré syndrome, other polyneuropathy and other neuropathy (brain tumours and injuries, intracerebral infarctions and haemorrhages, arteriovenous malformation).

Tables

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  • TABLE 1

    Number and proportion of all home mechanical ventilated patients in Finland in 2015–2019

    PatientsNew patients#Deceased patients¶Fully HIMV-dependent patients+MaleElectively initiated HIMV
    All patients§141 (100%)3446110 (82%)91 (67%)47 (34%)
    Motor neurone disease41 (29%)111636 (88%)20 (49%)18 (44%)
    Spinal cord injury28 (20%)8822 (79%)24 (86%)2 (7%)
    Miscellaneous25 (18%)5816 (64%)18 (72%)4 (16%)
    Muscular diseases21 (15%)7718 (86%)12 (57%)9 (43%)
    Duchenne muscular dystrophy20 (14%)4520 (100%)20 (100%)12 (60%)
    Post-polio syndrome5 (4%)024 (80%)2 (40%)2 (40%)

    Data are presented as n (%) or n. HIMV: home invasive mechanical ventilation. #: Patients whose treatment was initiated on 2 January 2015 to 1 January 2019; ¶: patients who died between 1 January 1 2015 and 1 January 2019; +: patients who use HIMV 24 h a day; §: “All patients” includes patients who were already on HIMV treatment on 1 January 2015 (n=107) and new patients whose treatment was initiated between 2 January 2015 and 1 January 2019 (n=34).

    • TABLE 2

      Specific data of diagnostic groups using HIMV in Finland in 2015–2019

      All patients (n=141)Motor neurone disease (n=41)Spinal cord injury (n=28)Miscellaneous (n=25)Muscular diseases (n=21)Duchenne muscular dystrophy (n=20)Post-polio syndrome (n=5)
      Age at diagnosis35.8±24.854.5±10.941.1±21.140.4±25.610.1±14.79.8±8.43.2±3.7
      Age at HIMV initiation years42.9±21.256.5±9.342.7±21.344.6±25.529.7±21.228.4±9.525.2±30.2
      Time from diagnosis to HIMV initiation years7.6±12.32.0±2.42.4±7.94.7±8.018.8±15.820.5±10.022.0±32.2
      Time from HIMV initiation to 1 January 2019 years12.3±11.47.7±5.19.4±7.912.0±9.719.9±13.911.0±7.747.3±24.2
      Lifetime of deceased patient years61.7±14.765.4±9.058.6±14.768.4±16.159.5±15.633.1±8.568.0±3.3
      HIMV duration of deceased patient years11.2±12.49.0±4.17.4±5.46.4±1.822.5±17.14.6±4.434.4±43.3
      Prevalence of HIMV per 100 000 people2.00.50.40.40.30.30.0

      HIMV: home invasive mechanical ventilation. All deceased patients were diagnosed before 1 January 2015.

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      Home invasive mechanical ventilation in Finland in 2015–2019
      Petra Kotanen, Hanna-Riikka Kreivi, Aki Vainionpää, Hannu Laaksovirta, Pirkko Brander, Waltteri Siirala
      ERJ Open Research Oct 2020, 6 (4) 00223-2020; DOI: 10.1183/23120541.00223-2020

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      Home invasive mechanical ventilation in Finland in 2015–2019
      Petra Kotanen, Hanna-Riikka Kreivi, Aki Vainionpää, Hannu Laaksovirta, Pirkko Brander, Waltteri Siirala
      ERJ Open Research Oct 2020, 6 (4) 00223-2020; DOI: 10.1183/23120541.00223-2020
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